Document Type : Original Article
Authors
Abstract
BACKGROUND: Depression is a disorder of the brain, a state of low mood and aversion to activity
that can affect a person’s thoughts, behavior, feelings, and sense of well‑being and can cause
alteration in sympathetic activity of the body, thus affecting heart rate variability (HRV).
AIM: The study was conducted to determine the effects of depression on HRV parameters in clinically
known cases of depression.
MATERIALS AND METHODS: A cross‑sectional (observational) study was conducted on fifty known
patients of depression, aged 18–65 years, and fifty healthy, age‑matched, normal controls. HRV test
was conducted, and the results were analyzed statistically using Student’s “t”‑test for equal variance,
for various parameters.
RESULTS: The study showed that the differences in mean R‑R interval(s), mean HR (beats/min),
very low frequency (VLF) power (milliseconds squared [ms2
]), and low frequency/high frequency
(LF/HF) power (%) (LF/HF ratio) among controls and cases were statistically highly significant, while
the differences in LF power (ms2
) in controls and cases were statistically significant. However, the
differences in basic anthropometric parameters, STD (standard deviation of the normal to normal)(s),
root mean square successive difference (ms), NN50 (count), pNN50 (%), VLF peak (Hz), LF peak (Hz),
HF peak (Hz), HF power (ms2
), VLF power (%), LF power (%), HF power (%), LF power (nu), and
HF power (nu) were found to be statistically insignificant.
CONCLUSION: Depression leads to changes in autonomic control of the body and changes the
autonomic balance in favor of an increased sympathetic tone, which can be detected with fair
accuracy with HRV analysis.
Keywords
- The National Institute of Mental Health: Available from: https://
www.nimh.nih.gov/health/topics/depression/index.shtml.
[Last accessed on 2018 Feb 25].
2. National Institutes of Health / U.S. National Library of Medicine.
Available from: https://medlineplus.gov/depression. [Last
accessed on 2018 Jan 11].
3. Chalmers JA, Quintana DS, Abbott MJ, Kemp AH. Anxiety
disorders are associated with reduced heart rate variability:
A meta‑analysis. Front Psychiatry 2014;5:80.
4. Koskie B. Depression: Facts, Statistics and You; 2018. Available
from: https://www.healthline.com/health/depression/
facts‑statistics‑ infographic#1. [Last accessed on 2019 Jul 25].
5. Carney RM, Freedland KE, Stein PK, Skala JA, Hoffman P,
Jaffe AS. Change in heart rate and heart rate variability during
treatment for depression in patients with coronary heart disease.
Psychosom Med 2000;62:639‑47.
6. Sathish B, Bhat R, Damodara M. Autonomic modulation in
different phases of menstrual cycle in young and older Indian
women. Int J Med Res 2013;1:12‑6.
7. Lee CL, Chang WD. The effect of cigarette smoking on aerobic
and anaerobic capacity and heart rate variability among female
university students. Int J Womens Health 2013;5:667‑79.
8. Tarvainen MP, Kubois NJ. HRV Users Guide. Ver. 2.1. Biosignal
Analysis and Medical Imaging Group (BSAMIG), Department
of Applied Physics, University of Eastern Finland, Kuopio,
FINLAND. MATLAB. Copyright 1984‑2012 The MathWorks, Inc.
MATLAB is a registered trademark of The MathWorks, Inc. 2012.
p. 8‑12.
9. Gritti I, Defendi S, Mauri C, Banfi G, Duca P, Roi GS. Heart rate
variability, standard of measurement, physiological interpretation
and clinical use in mountain marathon runners during sleep and
after acclimatization at 3480 m. J Behav Brain Sci 2013;3:26‑48.
10. Doss SS, Anandhalakshmi S, Rekha K, Akhil AK. Effect of
Smoking on heart rate variability in normal healthy volunteers.
Asian J Pharm Clin Res 2016;9:230‑34. - 11. Kaya H, Suner A, Koroglu S, Akcay A, Turkbeyler IH and
Koleoglu M. Heart rate variability in familial Mediterranean fever
patients. Europ J Rheumatol 2014;1:58‑61.
12. Karim N, Hasan JA, Syed SA. Heart rate variability – A review.
J Basic Appl Sci 2011;7:71‑7.
13. (Authors not listed) Heart rate variability: Standards of
measurement, physiological interpretation, and clinical use.
Task force of the European Society of Cardiology and the North
American Society of Pacing and Electrophysiology. Eur Heart J
1996;17:354‑81.
14. Sayar K, Güleç H, Gökçe M, Ismail AK. Heart rate variability in
depressed patients. Bull Clin Psychopharmacol 2002;12:130‑33.
15. Licht CM, de Geus EJ, Zitman FG, Hoogendijk WJ, van Dyck R,
Penninx BW. Association between major depressive disorder and
heart rate variability in the Netherlands study of depression and
anxiety (NSEDA). Arch Gen Psychiatry 2008;65:1358‑67.
16. Janca A, Hiller W. ICD‑10 checklist – A tool for clinicians use
of the ICD‑10 classification of mental and behavioral disorder.
Compr Psychiatry 1996;37:180‑7.
17. BMI Classification, Global Database on Body Mass Index. World
Health Organization; 2006.
18. Du Bois D, Du Bois EF. A formula to estimate the approximate
surface area if height and weight be known. Arch Intern Med.
1916;17:863‑71.
19. Agelink MW , Boz C, Ullrich H, Andrich J. Relationship between
major depression and heart rate variability. Clinical consequences
and implications for antidepressive treatment. Psychiatry Res
2002;113:139‑49.
20. Davidson J, Watkins L, Owens M, Krulewicz S, Connor K,
Carpenter D, et al. Effects of paroxetine and venlafaxine XR on
heart rate variability in depression. J Clin Psychopharmacol
2005;25:480‑4.
21. Kemp AH, Quintana DS, Felmingham KL, Matthews S, Jelinek HF.
Depression, comorbid anxiety disorders, and heart rate variability
in physically healthy, unmedicated patients: Implications for
cardiovascular risk. PLoS One 2012;7:e30777.
22. Brunoni AR, Kemp AH, Dantas EM, Goulart AC, Nunes MA,
Boggio PS, et al. Heart rate variability is a trait marker of
major depressive disorder: Evidence from the sertraline vs.
electric current therapy to treat depression clinical study. Int J
Neuropsychopharmacol 2013;16:1937‑49.
23. O’Regan C, Kenny RA, Cronin H, Finucane C, Kearney PM.
Antidepressants strongly influence the relationship between
depression and heart rate variability: Findings from the
Irish longitudinal study on ageing (TILDA). Psychol Med
2015;45:623‑36.
24. Sgoifo A, Carnevali L, Alfonso Mde L, Amore M. Autonomic
dysfunction and heart rate variability in depression. Stress
2015;18:343‑52.
25. Paniccia M, Paniccia D, Thomas S, Taha T, Reed N. Clinical
and non‑clinical depression and anxiety in young people:
A scoping review on heart rate variability. Auton Neurosci
2017;208:1‑14.
26. Chen X, Yang R, Kuang D, Zhang L, Lv R, Huang X, et al. Heart
rate variability in patients with major depression disorder during
a clinical autonomic test. Psychiatry Res 2017;256:207‑11.
27. Gehi A, Mangano D, Pipkin S, Browner W, Whooley M.
Depression and heart rate variability in patients with stable
coronary heart disease. Arch Gen Psychiatry 2005;62:661‑6.
28. Carney RM, Blumenthal JA, Stein PK, Watkins L, Catellier D,
Berkman LF, et al. Depression, heart rate variability, and acute
myocardial infarction. Circulation 2001;104:2024‑8.
29. Ha JH, Park S, Yoon D, Kim B. Short‑term heart rate variability
in older patients with newly diagnosed depression. Psychiatry
Res 2015;226:484‑8.
30. Wang Y, Zhao X, O’Neil A, Turner A, Liu X, Berk M. Altered
cardiac autonomic nervous function in depression. BMC
Psychiatry 2013;13:187.
31. Royster EB, Trimble LM, Cotsonis G, Schmotzer B, Manatunga A,
Rushing NN, et al. Changes in heart rate variability of depressed
patients after electroconvulsive therapy. Cardiovasc Psychiatry
Neurol 2012;2012:794043.
32. Askelrod S, Gordon D, Ubel FA, Shannon DC, Berger AC,
Cohen RJ. Power spectrum analysis of heart rate fluctuation:
A quantitative probe of beat‑to‑beat cardiovascular control.
Science 1981;213:220‑2.
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